MRS. SUSAN LOUISE CLARK (NPI# 1043525025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043525025 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN LOUISE CLARK |
| Credential | NP |
| Practice Address |
5701 Bow Pointe Dr Suite 225 Clarkston MI 48346-3198 |
| Practice Telephone | 2483848300 |
| Practice Fax Number | 2483848309 |
| Mailing Telephone | 2483848300 |
| Mailing Fax Number | 2483848309 |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2010-08-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
4704201015 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
4704201015 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161950 | Susan Marie Clark | Nurse Practitioner | 674 Coral Way, Winter Springs, FL 32708-3127 | 2020-07-09 |
| 1528591575 | Susan Clark | Counselor | 604 S Walnut, Stillwater, OK 74074-4222 | 2017-04-06 |
| 1790178556 | Susan March Clark | Peer Specialist | 3277 E 2nd St, Tulsa, OK 74104-2134 | 2015-03-17 |
| 1841537990 | Susan Noble Clark | Developmental Therapist | 1730 Radcliffe Rd, Montgomery, AL 36106-2620 | 2013-01-09 |
| 1881963411 | Susan Clark | Occupational Therapy Assistant | 38 Wheeler Ave, Warwick, NY 10990-1341 | 2011-12-28 |
| 1437302684 | Susan Maslin Clark | Chiropractor | 20416 Bowfonds St, Ashburn, VA 20147-7457 | 2008-11-01 |
| 1871780940 | Susan Marie Clark | Counselor | 112 S Water St Ste B, Kent, OH 44240-3689 | 2007-10-02 |
| 1750403861 | Susan M Clark | Psychologist | 1022 Cherokee Ave, Royal Oak, MI 48067 | 2007-04-06 |
| 1598892085 | Susan L Clark | Psychiatry & Neurology | 9515 60th Ave W, Mukilteo, WA 98275 | 2007-02-28 |
| 1609968692 | Susan M Clark | Pediatrics | 1318 S Main Road, Vineland, NJ 08360 | 2006-09-28 |
| Street Address |
5701 BOW POINTE DR SUITE 225 |
| City | CLARKSTON |
| State | MI |
| Zip Code | 48346-3198 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417955246 | James A Oneill | Pediatrics | 5701 Bow Pointe Dr, Suite 100, Clarkston, MI 48346-3198 | 2005-07-14 |
| 1154872190 | Bianca Green | Nurse Practitioner | 5701 Bow Pointe Dr, Clarkston, MI 48346-3198 | 2016-10-14 |
| 1437504149 | Sara Michelle Lebovic | Advanced Practice Midwife | 5701 Bow Pointe Dr, Suite 350, Clarkston, MI 48346-3198 | 2016-05-01 |
| 1649643263 | Michael Engler | Physician Assistant | 5701 Bow Pointe Dr, Clarkston, MI 48346-3198 | 2015-11-04 |
| 1285000869 | Sandra Aloia | Nurse Practitioner | 5701 Bow Pointe Dr, Ste 370, Clarkston, MI 48346 | 2015-08-18 |
| 1245621804 | Rochester Knee & Sports Medicine PC | Durable Medical Equipment & Medical Supplies | 5701 Bow Pointe Dr, Suite 300, Clarkston, MI 48346-3198 | 2015-02-18 |
| 1316371271 | Arli Susan Motsinger | Nurse Practitioner | 5701 Bow Pointe Dr, Suite100, Clarkston, MI 48346-3198 | 2013-08-28 |
| 1609200021 | Scott Walter Tycholiz | Physician Assistant | 5701 Bow Pointe Dr, Suite 120, Clarkston, MI 48346-3198 | 2013-08-22 |
| 1710239652 | Rebecca Lynn Warner | Physical Therapist | 5701 Bow Pointe Dr, Ste 300, Clarkston, MI 48346-3198 | 2012-10-02 |
| 1811262546 | Bradley Wallace Erlandson Sr. | Counselor | 5701 Bow Pointe Dr, Clarkston, MI 48346-3198 | 2012-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497399745 | Therapy Services of Clarkston LLC | Clinic/Center | 6770 Dixie Highway, Suite 103, Clarkston, MI 48346 | 2019-10-30 |
| 1679041545 | Shiba Lashon Nixon | Registered Nurse | New Oakland, 6549 Town Center Suite A, Clarkston, MI 48346 | 2018-11-08 |
| 1972079655 | Stephanie Gaumer | Social Worker | 6825 Dixie Hwy Ste E, Clarkston, MI 48346 | 2018-10-19 |
| 1912496324 | Regency At Independence Township, LLC | Skilled Nursing Facility | 6211 Stonewood Drive, Clarkston, MI 48346 | 2018-05-02 |
| 1558880591 | 3rd Circle Inc. | Home Health Aide | 39 South Main Street, Ste 2, Clarkston, MI 48346 | 2017-09-11 |
| 1376083246 | Rosemarie Villarreal | Social Worker | 4480 Elmdale Ave, Clarkston, MI 48346 | 2017-02-27 |
| 1932566940 | Syncere Hearts Home Healthcare, LLC | Home Health | 5836 North Marshbank Lane Apt203, Clarkston, MI 48346 | 2016-01-21 |
| 1649635087 | Coddaire & Associates, Inc. | Community/Behavioral Health | 6445 Citation Drive, Suite H, Clarkston, MI 48346 | 2015-12-30 |
| 1013386358 | Victoria Urikh-garcia | Technician, Other | 6510 Town Center Dr Ste E, Clarkston, MI 48346 | 2015-09-16 |
| 1194090993 | Stefanie Pavloski | Counselor | 5701 Bow Pointe Dr., Ste. #380, Clarkston, MI 48346 | 2012-03-13 |
| Find all providers in zip 48346 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013290 | Bradley David Winter | Nurse Practitioner | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-11-04 |
| 1750981577 | Irene Gwen Voss | Nurse Practitioner | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-10-30 |
| 1306476809 | Kathleen M Frybarger | Nurse Practitioner | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-01-23 |
| 1659919819 | Mayche Vang-kue | Nurse Practitioner | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2019-12-18 |
| 1952878092 | Cody William Shinavier | Nurse Practitioner | 6549 Town Center Dr Ste A, Clarkston, MI 48346 | 2018-10-26 |
| 1518485911 | Anthonia Chinedu Umelogu | Nurse Practitioner | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2017-09-06 |
| 1508234162 | Katherine Krajicek | Nurse Practitioner | 6549 Town Center Dr, Clarkston, MI 48346-4824 | 2015-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692494 | Memphis Chardell Sandoval | Nurse Practitioner | 131 S. Seaway Dr., Muskegon, MI 49441 | 2020-09-01 |
| 1588282784 | Mary Tackbary | Nurse Practitioner | 3932 W Briar Hill Dr, Maple City, MI 49664-9521 | 2020-07-14 |
| 1962032227 | Westlake Consultation Center | Nurse Practitioner | 4870 W Clark Rd Ste 100, Ypsilanti, MI 48197-1104 | 2020-01-24 |
| 1689211823 | Wanda Edwards | Nurse Practitioner | 29000 Inkster Rd Ste 115, Southfield, MI 48034-1097 | 2019-12-06 |
| 1508416355 | Stephanie Lauren Marl | Nurse Practitioner | 29800 Adams Dr, Gibraltar, MI 48173 | 2019-09-13 |
| 1457905614 | Natalie Poole | Nurse Practitioner | 23077 Greenfield Rd Ste 260, Southfield, MI 48075-3745 | 2019-07-26 |
| 1629535117 | Valerie Baunoch | Nurse Practitioner | 2057 E West Maple Rd, Commerce Twp, MI 48390 | 2019-02-21 |
| 1790293488 | Infinity Hope Center LLC | Nurse Practitioner | 260 Vinewood St Ste 100a8919, Detroit, MI 48216-1667 | 2018-01-16 |
| 1033659644 | Anne Zamler | Nurse Practitioner | 14230 W Mcnichols Rd, Detroit, MI 48235-3912 | 2017-03-01 |
| 1396289120 | Next Level Up Health & Wellness Inc. | Nurse Practitioner | 28423 Parkwood St, Inkster, MI 48141-1669 | 2016-12-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.